ECG Quest > Basics > Axis > Left Axis Deviation

Left Axis Deviation

A left axis deviation means that the overall direction of ventricular depolarisation is abormal and too far around towards the left shoulder. This direction can be between -30 degrees (up towards the left shoulder) to -90 degrees (vertically upwards) from horizontal. If the axis is leftward, Lead I will be positive, aVF negative and lead II negative.

Left Axis Deviation can be caused by lots of things, including left ventricular hypertrophy, left bundle branch block, inferior MI, ventricular pacing, and others. The diagnosis of exclusion is left anterior fascicular block.

See also: Axis

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References

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In the ECGquest archives, this ECG has been tagged with: - Syncope Left Axis Deviation Regular Tachycardia Fragmented QRS 12-Lead ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG : Syncope and tachycardia

This ECG is from a man in his 50s who presented with syncope on a background of diabetes, opiate abuse and possible prior cardiac disease.

This ECG shows a supraventricular tachycardia with evidence of P waves, left axis deviation and slightly wider QRS (106 msec) likely due to LAFB, tall QRS concerning for LVH and fragmentation in V2-4 suggesting prior MI.

In the ECGquest archives, this ECG has been tagged with: - Syncope Left Axis Deviation Normal rate Long PR RSR' Wide QRS First degree AV block LAFB RBBB 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 26th November 2018 – Interpretation

This ECG is from a man in his 60s who presented after an episode of syncope.

This ECG shows bifascicular block (RBBB + LAFB) with a first degree AV block. He underwent pacemaker insertion.

In the ECGquest archives, this ECG has been tagged with: - Left Axis Deviation Bifascicular block LAFB RBBB 12-Lead ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Bifascicular Block

This ECG is from a woman in her 70s who presented with sepsis.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Bradycardia Left Axis Deviation Extra P waves Second degree AV block 2:1 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 29th October 2018 – Interpretation

This ECG is from a woman in her 80s who presented with intermittent chest pain and dyspnoea.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Left Axis Deviation Normal rate Regular Anterior ST elevation Long PR Acute Anterior MI 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 22nd October 2018 – Interpretation
In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Electrode misplacement Left Axis Deviation Lateral ST elevation LAFB RBBB Acute Anterior MI Acute Lateral MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A man in his 80s with chest pain

This ECG is from a man in his 80s who presented with chest pain and shortness of breath. This was the repeat ECG just before he arrested.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Left Axis Deviation Regular Long PR Pathological Q waves Wide QRS First degree AV block RBBB 12-Lead ECG Guru CC-BY-NC-SA
Instructors’ Collection ECG: Right Bundle Branch Block With Probable Previous M.I.

This ECG is from an 87 year old man who presented with chest discomfort.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Dyspnoea Left Axis Deviation Regular Tachycardia Excessive discordant ST depression. Excessive discordant ST elevation R in aVR Wide QRS Ventricular tachycardia Acute Lateral MI Acute Posterior MI 12-Lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer Dr Stephen W. Smith CC BY-NC
Posterolateral OMI resulting in VT, then R-on-T phenomenon and VF – repeat after sudden worsening of shortness of breath.

This ECG is from a man in his 50s who presented with 1 hour of chest pain and shortness of breath. This was his second ECG after he suddenly became more short of breath.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Left Axis Deviation Hyperacute T waves Sinus bradycardia Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A Tale of 2 Occlusions in the Same Patient: one with Expert ECG interpretation, the Other Without – second ECG, as pain returned 40 min later

This ECG is from a man in his 40s who presented with chest discomfort and diaphoresis since waking a few hours earlier, on a background of prior infarction with PCI years ago, active smoking, high cholesterol and hypertension. This was the repeat ECG 40 min after arrival, when pain returned.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Left Axis Deviation Anterior ST elevation Hyperacute T waves Inferior ST elevation Acute Anterior MI 12-Lead Serial 12-lead Dr Pendell Meyers Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A Tale of 2 Occlusions in the Same Patient: one with Expert ECG interpretation, the Other Without – repeat with worsening pain

This ECG is from a man in his 40s who presented with chest discomfort and diaphoresis since waking a few hours earlier, on a background of prior infarction with PCI years ago, active smoking, high cholesterol and hypertension. This was the repeat ECG 12 minutes after the pain increased.

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